ABSTRACT
The advantages of laparoscopic approach to colectomy are largely related to a relatively small abdominal incision that reduces wound complications and postoperative pain, and results in modest reductions in the duration of postoperative ileus and improvements in postoperative functional status. Excluding those surgeons who perform transrectal or transvaginal specimen extraction, the majority of surgeons utilize an abdominal incision of 4–8 cm to extract the colectomy specimen. This incision can also be used to perform mesentery division and anastomosis, provided that adequate mobilization of the colon has been accomplished intracorporeally. If such an incision is to be made at some point during the operation, it seems sensible to make it at the start of the procedure and utilize it throughout. The current generation of hand-assist devices allows this concept to be put into practice to facilitate the performance of laparoscopic colectomy. Hand-assist technology allows the novice laparoscopic colectomist to improve tactile sensation and proprioception, and allows the experienced surgeon to approach complex problems laparoscopically and potentially shorten operative times.
